Individual provider Active NPI

Joseph Winter Kotnour, PA

  • Physician Assistant
  • Federal Way, WA
National Provider Identifier
1093223299
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60969088 Issued in WA
Practice address
34515 9TH Ave S
Federal Way, WA 98003-6761
Phone
(253) 426-6341
Fax
(253) 426-6344
NPI assigned
Jan 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60969088 WA Primary

Addresses

Primary practice location

34515 9TH Ave S
Federal Way, WA 98003-6761

Mailing address

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 426-6341

Other practice location 1

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 922-4281

Other practice location 2

201 16th Ave E
Seattle, WA 98112-5226
Phone (206) 326-3000

Other identifiers 1

IdentifierTypeStateIssuer
2138465MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jkotnour509758@fhsce.catholichealth.net Direct
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191009002391 WA Practitioner - Physician Assistant 4284989997 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 426-6341

11567 Canterwood Blvd NW
Gig Harbor, WA 98332-5812
Phone (253) 426-6341

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008676GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Dec 14, 2020 Accepting new patients
Franciscan Medical Group Physician Assistant CurrentSince Dec 14, 2020 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 11, 2021 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Locations

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

1455 Battersby Ave
Enumclaw, WA 98022
Phone (253) 552-5615

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

201 16th Ave E
Seattle, WA 98112
Phone (206) 326-4545

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: jkotnour3851785@ghc.direct-ci.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1093223299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34515 9TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036761",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34515 9TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036761",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Watson Blvd",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310933431",
            "country_code": "US",
            "telephone_number": "478-922-4281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 16th Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981125226",
            "country_code": "US",
            "telephone_number": "206-326-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTNOUR",
        "first_name": "JOSEPH",
        "middle_name": "WINTER",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-22",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60969088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2138465",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkotnour509758@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "34515 9th Ave S",
            "city": "Federal Way",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980036761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "201 16th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.